I know a person who grinds his teeth during sleep. With grinding sounds loud enough to be heard over the next room! That person is me.

The habitual act of teeth clenching and grinding is called bruxism. It is now one of the most vexing issues in dentistry today due to its implications.

There are 2 types: awake bruxism, and sleep bruxism. One happens consciously or semi-voluntariry while you are awake. While the other occurs subconsciously during sleep.

Many people are unaware of this condition, but it is a common problem, with a prevalence range from 8-31% of the general population. Those who brux are known as "bruxists" or "bruxers".

Several symptoms are commonly associated with bruxism, including hypersensitive teeth, jaw ache, and in some cases, headache. A quick check: do you sometimes wake up having these symptoms?

Why do people grind their teeth then? Glad you asked.

There are 4 factors contributing to this condition.

1) Genetic

Since there is a high percentage of people with sleep bruxism who have a direct family member also having sleep bruxism during childhood, there are suggestions of genetic factors at play. However, no genetic markers have yet been identified at the moment. Do any of your family members have the habit of teeth grinding?

2) Psychosocial

Studies are showing that emotional stress is the key triggering factor for bruxism. This is often noticeable during the period of examinations, family bereavements and marriages. Though stress has a stronger relationship to awake bruxism, the role of stress in sleep bruxism is less obvious.

3) Medications

Some drugs are known to trigger anxiety in certain individuals. Example includes dopamine agonists and antagonist, tricyclic antidepressants, selective serotonin reuptake inhibitors, and amphetamines. In addition, excessive consumption of caffeine may exacerbate the condition. Coffee and tea drinkers, should take note.

4) Occlusal

An occlusal interference may refer to a problem that interferes with the normal path of the bite, and is usually used to describe a localized problem with the position or shape of a single tooth or group of teeth.

How I managed bruxism:

I tried to relax before sleeping but that did not work for me, though.

Hence, I took the next practical step by wearing a dental guard (occlusal splint). This prevents the upper and lower teeth from contacting. It can be uncomfortable wearing the device initially and may cause some sleepless nights. However, you will soon get used to it.

I have 2 of these so far. My current occlusal splint is the clearer, Essix type, which is also used as a retainer for those who undergone orthodontic treatment. You can get these at most dental clinics. An impression is required for construction of the dental guard, and it may be ready within a week.

As you can see in the above picture, the first occlusal splint of mine has worn out, evident by a hole through the acrylic material. This shows that the force of clenching and gnashing is indeed strong.

Tips for dental guard wearers:a) Wear it 30 minutes before going to bed so that the device is conditioned properly in your mouth.b) As an added measure for sensitive teeth, you can apply a layer of desensitizing toothpaste on the fitting surface of the dental guard before wearing it.c) Avoid sleeping sideways to prevent drooling.d) When you wake up, observe the condition of the dental guard for signs of wear.e) Do your previous symptoms, e.g. sensitive teeth, jaw ache, headache still persist? Consult your dentist if it still does.f) Stop wearing once there is a noticeable hole through the device and replace with a new one.

There are also other treatment modalities such as relaxation therapies, bruxism biofeedback headbands, medications etc. What we have in Malaysia now currently is the occlusal splint as our commonest solution. Although this by itself does not actually stop the habit of excessive grinding, it works excellently to prevent tooth wear.

Written & Contributed by

Edward TayHe is currently a final year dental student at University of Malaya. His passion to equip patients in achieving optimal oral self-care. Other interests include social media, online marketing and music. Follow him on Twitter @iamedwardtay

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